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Optimization of Liver Iron Load Assessment by Pixel-Based T2* MRI in Thalassemic Patients

Open Journal of Radiology 2012年第2期2卷 46-51页

作者： neda gholizadeh Shahram Akhlaghpoor Hamid Soltanian-Zadeh Emad Fatemizadeh Mohammad Reza Alinaghizadeh Amin Shams Akhtari Mohammad Nourizadeh Cardivascular Disease Research Center Ahvaz Joundishapour University Ahvaz Iran Control and Intelligent Processing Center of Excellence (CIPCE) School of Electrical Engineering College of Engineering University of Tehran Tehran Iran Department of CT & MRI Imaging Tehran Medical Imaging Center Tehran Iran Department of Magnetic Resonance Imaging Noor Medical Imaging Center Tehran Iran Department of Nuclear Engineering Science and Research Branch of Azad University Tehran Iran School of Electrical Engineering Sharif University of Technology Tehran Iran

Purpose: To improve liver iron load assessment by investigating the precision of different approaches of T2* Measurement. Background: Iron overload is a major problem in the treatment of thalassemic patients. Liver iron concentration (LIC) is an important index toward the management of body iron load. The accuracy of iron load estimation may suffer from the methodology of T2* measurement and there is no complete agreement upon the best approach of T2* calculation. Methods: 32 β-thallasemic patients (18 male) with the mean age of 20.0 ± 6.5 years were involved in this study. A multi-echo fast gradient-echo technique on a 1.5 T MRI system was used to measure liver iron overload and the T2* map of liver was reconstructed on a pixel-by-pixel basis. The T2* map and MRI images were utilized to deter- mine accurate location of ROI (region of interest). The mean of T2* were computed from the ROIs. The reproducibility of calculated T2* values in two methods were obtained. Moreover, the mean of the pixel’s T2* was calculated in the entire liver parenchyma of one slice. The T2* value of the entire slice was compared with the ROI approach. Results: In the ROI based method, the CoV for the intra-observer reproducibility was 8.5% and for the inter-observer was 9.78%. In the pixel based method, the CoVs for intra-observer and inter-observer reproducibility were 2.79% and 3.91%. There was an acceptable correlation (r = 0.96) between the T2* values calculated by the ROI and the entire slice. Conclusions: The pixel-based approach is more precise to determine the appropriate placement of the ROI. The assessment of T2* in the entire slice reduces the user-based errors significantly.

关键词： Thalassemia Liver Iron Overload MRI T2*

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The coast and benefits of helicopter emergency medical services instead of the ground unit in traumatic patients: A cost-effectiveness analysis

引用

Health 2013年第5期5卷 903-907页

作者： Amin Shams Akhtari Naghmeh Sadat Jafari Hamid Kariman Afshin Amini Vahid Monsef Mohamad Noorizadeh neda gholizadeh Department of Emergency Medicine Gilan University of Medical Sceince Rasht Iran Department of Emergency Medicine Shahid Beheshti University of Medical Science Tehran Iran Department of Forensic Medicine and Traumatic Pathology Alborz University of Medical Science Karaj Iran Department of Radiation Medical Engineering Isfahan University Isfahan Iran Research Committee of Medical Science Jondishapour University of Medical Science Ahvaz Iran

Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care;however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and?Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90;95% confidence interval [CI] 1.60 to 2.25;P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36;95% CI 1.18 to 1.58;P: 0001). Conclusion: Here we analyze a large database of patients with moderate to severe traumatic brain injury. Aeromedical response appears to yield no significantly improved outcomes after adjustment for multiple influential factors in patients with moderate to severe traumatic brain injury.

关键词： Emergency Traumatic Patients Aero Medical

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